Misawa K
Second Department of Internal Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
Hokkaido Igaku Zasshi. 1989 Nov;64(6):792-812.
This study was designed to evaluate, using compartmental model analysis, the effects of jet injection, changes in injected dosage, and mixture of short- and intermediate-acting insulin preparations on the absorption kinetics of human insulin (HI) mainly in rabbits. The following results were obtained. (1) It was found that a split-pool model was adequate for the evaluation of the absorption kinetics of insulin. (2) Jet injection resulted in more rapid absorption of insulin than needle injection. Since parameter K12 (inter-pool rate constant) of jet injection was three times as large as that of needle injection, the accelerated absorption by jet injector could result from the rapid movement of insulin from the injection site to the absorption site. (3) A negative correlation between insulin dosage and Kd (degradation rate constant) was observed, suggesting that the process of subcutaneous absorption of insulin includes a nonlinear component. (4) The prompt injection of Actrapid HI mixed with Monotard HI in a single syringe caused a delayed absorption of Actrapid HI. In contrast, there was no prolonged absorption after the injection of regular HI mixed with NPH-HI in a single syringe. There was a significant positive correlation between the percent change of K12 (in separate injection and mixed injection) in vivo and the recovery rate of short-acting insulin when mixed with intermediate-acting insulin in vitro. In clinical studies of diabetic subjects, higher serum free insulin levels before noon and higher K12 values were observed after the mixed injection of regular HI and NPH-HI, compared with that of Actrapid HI and Monotard HI. These results suggest that the application of compartmental model analysis is useful to studying the absorption kinetics of subcutaneously injected insulin.
本研究旨在运用房室模型分析评估喷射注射、注射剂量变化以及短效和中效胰岛素制剂混合使用对主要在兔体内的人胰岛素(HI)吸收动力学的影响。获得了以下结果。(1)发现分流池模型适用于评估胰岛素的吸收动力学。(2)喷射注射导致胰岛素的吸收比皮下注射更快。由于喷射注射的参数K12(池间速率常数)是皮下注射的三倍,喷射注射器加速吸收可能是由于胰岛素从注射部位快速移动到吸收部位所致。(3)观察到胰岛素剂量与Kd(降解速率常数)之间呈负相关,提示胰岛素皮下吸收过程包括非线性成分。(4)在单个注射器中快速注射混合了慢胰岛素锌悬液的中性胰岛素导致中性胰岛素吸收延迟。相比之下,在单个注射器中注射混合了低精蛋白锌胰岛素的普通胰岛素后没有吸收延长。体内单独注射和混合注射时K12的变化百分比与体外短效胰岛素与中效胰岛素混合时的回收率之间存在显著正相关。在糖尿病受试者的临床研究中,与混合了慢胰岛素锌悬液的中性胰岛素相比,混合注射普通胰岛素和低精蛋白锌胰岛素后,中午前血清游离胰岛素水平更高,K12值也更高。这些结果表明,房室模型分析的应用有助于研究皮下注射胰岛素的吸收动力学。